This application is a resubmission of the application submitted in response to RFA-CA-09-022. We appreciate the comments from the reviewers following that submission. The areas of concern have been reviewed and we have reworked the document to address those areas. The VMCCOP has been in existence since 1983 and is one of 27 CCOP grants continuously funded. Our CCOP is comprised of 6 hospital based practices spanning over Washington and Alaska. The VMCCOP core component is comprised of Virginia Mason Medical Center (VMMC) and 5 additional satellite locations in the greater Seattle area. Our component sites include Fairbanks Cancer Treatment Center (Fairbanks Memorial Hospital), Fairbanks AK;Providence Cancer Center (Providence Alaska Medical Center), Anchorage AK;Evergreen Medical Center, Kirkland WA;Valley Medical Center, Renton WA;and Pacific Medical Center, Seattle WA. It is the intent of the VMCCOP to continue to expand clinical research opportunities for our cancer patients. Specific aims of the VMCCOP are outlined below: 1. Maintain and continue our growth in enrollment to treatment and cancer control trials. 2. Increase affiliation participation surrounding enrollment and national participation. 3. Continue to improve our quality and data integrity surrounding our clinical trials. 4. Improve upon our research efficiency by creating standards surrounding study start-up, coordinator hand-offs and subject visits. RELEVANCE: It is estimated that there will be 1,529,560 new cancer cases diagnosed in the United States in 2010, and 569,490 cancer deaths. In providing access to clinical research trials in the treatment and prevention of cancer to the patient population throughout Washington and Alaska, the VMCCOP hopes to contribute to reductions in cancer incidence and mortality.